In the years that I have worked with addiction, I have learned more than I knew before I started. None of my degrees could have taught me everything I have picked up through experience. This is not the fault of the courses and textbooks, however. It is simply impossible to put down all your preconceived notions and subconscious beliefs without dealing with addiction on a day-to-day basis.
Addiction often seems like a simple problem from the outside. It looks like a case of lack of impulse control. But while low impulse control can contribute to the development of substance abuse, and increasing impulse control can help treat it, there is a lot more to it than that.
I’d like to share with you some of the most important insights I’ve learned about addiction.
These are 5 of the most important things I’ve found that most people misunderstand.
1. Addicts are Highly Sensitive People (HSPs)
There’s an unfortunate perception that addicts are either irresponsible kids, rebels against society, or even hardened criminals. The reality is very different. In my work with addicts, I’d estimate that at least 80% of them have been what I call HSPs – highly sensitive people. It is HSPs who are most likely to get addicted to a substance or behavior, as they attempt to escape from a chaotic inner world.
HSPs seek relief from their own intense emotional pain, abandonment or loneliness. They experience emotional pain at a higher intensity than most of us, and struggle to cope with it in healthy ways.
2. Addicts are rarely selfish by nature
Addiction can make people incredibly selfish. They end up hurting their family, friends, and strangers when prioritising substance use above all else. They sabotage their relationships, which is why some programs place such importance on seeking forgiveness in an individual’s recovery.
But addicts are rarely selfish by nature. HSPs are not only sensitive to their own pain, but to the pain of others as well. Their high levels of empathy often lead them to take on the pain of others, rather than merely being a comforting and supportive presence.
3. Addiction is often accompanied by other mental illnesses
In as many as 70% of cases, addiction is accompanied by at least one other mental illness. Depression and anxiety are the most common, as the addict seeks to escape from crushing feelings of emptiness. Studies suggest that these disorders are not caused by the substance abuse, but exist beforehand.
Because of this, treating the addiction alone is often not effective enough. The co-occurring disorders need to be treated as well in order to lead to positive outcomes and prevent the risk of relapse.
4. Moderation can work
Most programs designed to combat addiction emphasise cutting out all substance use. Moderation is not seen as an option. Drug users are encouraged not to drink alcohol, even if that was never a part of their addiction.
I respectfully disagree. In my experience, moderate use of legal substances (such as alcohol, cigarettes, and marijuana) can be a realistic goal. I have worked with many former addicts who successfully moderated their use of these substances. Of course, each individual is different, and the possibility of moderate use of legal substances needs to be assessed on a case-by-case basis.
5. Nothing is more powerful than human thought
Finally, something I emphasise in treatment of substance abuse and many other mental illnesses, is that there is nothing more powerful than human thought. We see this in the success of placebos and nocebos. The belief that medication is working can make a patient feel better, and the belief that a substance is causing harm can cause negative effects.
For this reason, I believe that addicts are not powerless over their addictions. It will take a lot of training in order to combat the addiction successfully, but I have seen it done over and over again. I’m a supporter of all programs that successfully help addicts combat addiction. My personal approach, however, focuses on using the mind as the most important tool in recovery.
An addict’s determination to beat their addiction is the necessary first step. Once we have that commitment, it is a matter of time and training before s/he is well on the way to recovery.
Dr. Nancy Irwin is co-author of "Breaking Through, Stories of Hope and Recovery" and a Primary Therapist at Seasons in Malibu World Class Addiction and Mental Health Treatment Center.